EORTC presents new results in neuro-oncology at EANO

The 2026 congress of EANO, the European Association of Neuro-oncology, held in Rome in late September, saw the presentation of important new results from EORTC studies. EANO is Europe’s multidisciplinary neuro-oncology organisation representing all medical and scientific disciplines involved in the prevention, diagnosis, and treatment of tumours of the central and peripheral nervous system including neurology, neurosurgery, radiation oncology, medical oncology, paediatric neuro-oncology, and neuropathology.

Major trial answers a longstanding question in atypical meningioma care

Trial chief investigator Dr Michael D Jenkinson, from the University of Liverpool, Liverpool, UK, presented ROAM/EORTC 1308, which looked at people with an atypical meningioma, a type of tumour arising from the coverings of the brain. Even when these tumours are completely removed by surgery, they can grow back.

The study set out to look at whether giving radiotherapy shortly after surgery was better than careful monitoring with regular scans. A total of 157 patients from 12 countries took part. Half received radiotherapy after surgery, and half were monitored without immediate further treatment. After five years about 80% of patients who received radiotherapy were alive without the tumour having returned, compared with about 62% of those who were simply monitored. Overall, the tumour returned in 11 of 78 patients given radiotherapy, and in 24 of 79 patients under observation.

Most patients did not develop serious long-term side effects, although moderate or severe late effects linked to radiotherapy occurred in five patients. Reported quality of life was not worse in the radiotherapy group. These results suggest that radiotherapy should be considered after complete removal of an atypical meningioma. The best choice will differ from person to person and should be discussed with the specialist team, taking account of the expected benefit, possible side effects, general health and personal preferences, the researchers say. However, the study was not large enough to give a clear answer about whether radiotherapy helps people live longer.

Dr Jenkinson said: “For patients and their families, one of the hardest questions to address after surgery is whether additional treatment is needed. This trial shows that radiotherapy after complete removal of an atypical meningioma can significantly reduce the chance of the tumour coming back, while maintaining quality of life and causing very few long-term side effects.”

IDH-mutant Glioma

Results from the phase III INDIGO trial have shown that patients with IDH-mutant diffuse gliomas who took vorasidenib while being monitored (“watch and wait”) after biopsy or resection, but before starting standard radiochemotherapy, had improved progression-free survival. Vorasidenib is an oral, targeted inhibitor of mutant IDH1 and IDH2. Its use as maintenance therapy after radiochemotherapy remains unclear.

The VIGOR trial (EORTC-2427-BTG; NCT06809322) is an intergroup trial led by the EORTC conducted together with COGNO¹ and the Canadian Clinical Trials Group and will enroll 468 adults with grade 2 or 3 IDH-mutant astrocytoma who have completed standard radiochemotherapy. Half will receive daily 40g vorasidenib, and half a placebo for up to five years until unacceptable toxicity, or withdrawal of patient consent occurs. Enrolment started in January 2026 and patients will be recruited from multiple international territories including Europe, Australia, and Canada. After completion of the study treatment or following its discontinuation, participants will be followed up until the end of study visit, death, consent withdrawal or lost to follow-up, whichever occurs first. While the trial’s main goal is to see whether vorasidenib delays the tumour from growing back or progressing, it will also investigate overall survival, side effects, quality of life, neurocognition and other aspects of translational research.

“If it shows benefit, vorasidenib could join the standard treatments already being used for this tumour type,” said the study co-coordinator Dr Marjolein Geurts, from the Erasmus MC Cancer Institute, Rotterdam, The Netherlands, presenting the trial.

Dr Matthias Preusser, from the Medical University of Vienna, Austria the coordinator of the VIGOR trial, said: “We are grateful for the support of our investigator network and the trust placed in us by our patients, which allowed us to successfully activate the trial and establish a very satisfying pace of recruitment.”

The trial received funding from Servier.

Diffuse Glioma Quality of life

Patients with diffuse glioma often experience a wide range of symptoms, such as fatigue, difficulty thinking clearly, and physical weakness, that affect their quality of life. However, how these symptoms relate to each other and their precise effect on quality of life remain unclear. Results from an EORTC study using data from nearly 2,840 patients across seven European trials can now help clarify the interrelationships between symptoms.

Using a statistical technique called network analysis, the researchers investigated how symptoms, functional abilities, and clinical factors such as age, tumour grade, and steroid use relate to each other. They found that clinical factors such as tumour grade and type of surgery, although closely linked to each other, were only weakly linked to how patients felt or functioned in their daily lives. Consistent with this finding, symptom interconnectedness (global strength) did not differ between networks stratified by disease severity, disease phase, or physical functioning. In contrast, the number of interconnections was higher among patients with cognitive complaints and those with high fatigue levels.

Presenting the results, Ms Maxine Gorter, from the Amsterdam Cancer Centre, The Netherlands said: “These findings suggest that fatigue and cognitive problems may be especially important targets for doctors to address in these patients, since improving them could have benefits for other symptoms and overall quality of life.”

RTQA in glioblastoma

EORTC Fellow Dr Raffaella De Pietro presented results from the ARGOS, a post hoc radiotherapy quality assurance (RTQA) analysis of the phase III EORTC-1709-BTG /CCTG CE.8 (MIRAGE) trial. RTQA is an essential component of radiotherapy trials, helping to ensure treatment consistency and the reliability of trial results.

MIRAGE evaluated the addition of the proteasome inhibitor marizomib to standard temozolomide-based chemoradiotherapy in patients with newly diagnosed glioblastoma. The ARGOS analysis investigated whether RTQA compliance and radiation dose to brain tissue outside the planning target volume (PTV – the area requiring treatment plus a safety margin to account for small variations in patient positioning) – were associated with survival outcomes and overall toxicity burden. The analysis included 672 patients. RTQA compliance was not significantly associated with the outcomes that were evaluated. However a higher mean dose to the uninvolved brain, defined as the whole brain minus the PTV, showed exploratory associations with worse overall and progression-free survival, and a greater toxicity burden.

“These findings underline the importance of evaluating uninvolved brain dose metrics as potential RTQA endpoints in glioblastoma radiotherapy” says Dr De Pietro. “Reducing unnecessary radiation exposure to healthy brain tissue may also help preserve future treatment options, including re-irradiation in the event of recurrence.”

1.COGNO is a not-for-profit network of healthcare professionals, researchers and consumer representatives dedicated to improving survival and quality of life for people affected by brain and spinal tumours.